不伴认知障碍的2型糖尿病患者的脑血流改变  

Altered Cerebral Blood Flow in Type 2 Diabetes Mellitus Without Cognitive Impairment

作　　者：杨佳盈 张学威 刘雪清 周佳敏 何淼 李静[3] 邵暇荔 李文慧 管宇宙 张伟宏 冯逢[1] YANG Jiaying;ZHANG Xuewei;LIU Xueqing;ZHOU Jiamin;HE Miao;LI Jing;SHAO Xiali;LI Wenhui;GUAN Yuzhou;ZHANG Weihong;FENG Feng(Department of Radiology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China;Department of Interventional Radiology,Emergency General Hospital,Beijing 100020,China;Department of Neurology,The First Affiliated Hospital of Tsinghua University,Beijing 100016,China;Department of Radiology,Zhongshan Hospital,Fudan University,Shanghai 200032,China;Department of Endocrinology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China;Department of Neurology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China)

机构地区：[1]中国医学科学院、北京协和医学院、北京协和医院放射科,北京100730 [2]应急总医院介入放射科,北京100020 [3]清华大学附属第一医院神经内科,北京100016 [4]复旦大学附属中山医院放射科,上海200032 [5]中国医学科学院、北京协和医学院、北京协和医院内分泌科,北京100730 [6]中国医学科学院、北京协和医学院、北京协和医院神经内科,北京100730

出　　处：《中国医学科学院学报》2025年第2期219-225,共7页Acta Academiae Medicinae Sinicae

基　　金：国家自然科学基金(81871335);北京协和医院中央高水平医院临床科研专项(2022-PUMCH-B-067)。

摘　　要：目的利用动脉自旋标记技术探寻不伴认知障碍的2型糖尿病(T2DM)患者的脑血流灌注(CBF)改变。方法纳入不伴认知障碍的T2DM患者23例(T2DM组),以及年龄、性别、受教育年限相匹配的健康对照23名(对照组),采集两组受试者临床资料,并行神经心理学测试及头颅MRI扫描。比较两组临床资料、神经心理学及全脑平均和局部zCBF值(z变换后的相对CBF值)差异,最后提取T2DM患者差异显著脑区的zCBF值与临床变量、神经心理学结果行偏相关分析(控制年龄、性别及受教育年限)。结果T2DM组全脑平均zCBF值与对照组相比差异无统计学意义(P=0.155),而T2DM组左侧颞上回及左侧岛叶的zCBF值显著高于对照组(高斯随机场校正,初始阈值P<0.001,簇水平P<0.05),但左侧颞上回及左侧岛叶的zCBF值与临床资料和神经心理学指标之间均无相关性(P均>0.05)。结论T2DM患者局部脑血流改变先于认知功能变化,动脉自旋标记技术有望用于早期监测T2DM患者认知功能损害的相关脑血流改变。Objective To investigate the alterations of cerebral blood flow(CBF)in type 2 diabetic mellitus(T2DM)patients without cognitive impairment by using arterial spin labeling(ASL)technique.Methods A total of 23 T2DM patients without cognitive impairment and 23 healthy controls(HC)matched by age,sex,and education attainment were recruited.Their clinical data were collected,and neuropsychological tests and cerebral magnetic resonance imaging were performed.Then,the outcomes of clinical features,neuropsychological tests,and global and regional CBF were compared between the two groups.The significant regional zCBF(z-transformed relative CBF)values were extracted and correlated with clinical data and neuropsychological scores in T2DM patients,controlling age,sex,and education.Results No significant difference was found in whole brain CBF between the two groups(P=0.155),while significantly higher CBF was identified in the left superior temporal gyrus and left insula in the T2DM group(Gaussian random field correction,initial threshold P<0.001,cluster level P<0.05).No correlation was observed between the significant regional zCBF values and the clinical data or the neuropsychological scores in T2DM patients(all P>0.05).Conclusion Alterations in cerebral hemodynamics may precede cognitive function changes in T2DM,suggesting that the ASL technique is promising for early monitoring of cerebral hemodynamic changes associated with cognitive impairment in patients with T2DM.

关 键 词：2型糖尿病 动脉自旋标记 脑血流灌注 

分 类 号：R455[医药卫生—运动医学]